[关键词]
[摘要]
目的 研究安宫牛黄丸联合阿加曲班注射液治疗急性脑梗死的临床疗效。方法 选取2017年10月-2019年10月在河南中医药大学第三附属医院治疗的120例急性脑梗死患者为研究对象,将所有患者随机分为对照组和治疗组,每组各60例。对照组患者静脉泵注阿加曲班注射液,10 mg溶于100 mL生理盐水,持续静脉泵注3 h,2次/d。治疗组在对照组基础上口服安宫牛黄丸,1丸/次,1次/d。两组患者接受治疗时间为4周。观察两组的临床疗效,比较两组Barthel指数、美国国立卫生研究院卒中量表(NHISS)评分、大脑平均血流速度和血液学指标[神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)和白细胞介素-8(IL-8)]。结果 治疗后,治疗组总有效率(95.00%)显著高于对照组(83.33%)(P<0.05)。治疗后,两组Barthel指数显著升高,NHISS评分显著降低(P<0.05);且治疗组Barthel指数、NHISS评分改善较明显(P<0.05)。治疗后,两组患者大脑中动脉、大脑前动脉、大脑后动脉的平均血流速度均明显升高(P<0.05);且治疗组患者平均血流速度升高较明显(P<0.05)。治疗后,两组患者血清NSE水平明显降低,BDNF水平明显升高(P<0.05);且治疗组血清NSE、BDNF水平改善较明显(P<0.05)。治疗后,两组患者血清hs-CRP、TNF-α、IL-8水平明显降低(P<0.05);且治疗组患者血清hs-CRP、TNF-α和IL-8水平均降低较为明显(P<0.05)。结论 安宫牛黄丸联合阿加曲班注射液治疗急性脑梗死具有较好的临床疗效,能够改善患者神经功能和生活质量,调节血液学指标,值得在临床上推广应用。
[Key word]
[Abstract]
Objective To study the efficacy of Angong Niuhuang Pills combined with Argatroban Injection in treatment of acute cerebral infarction. Methods Patients (120 cases) with acute cerebral infarction in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine from October 2017 to October 2019 were randomly divided into control and treatment groups, and each group had 60 cases. Patients in the control group were given Argatroban Injection, 10 mg added into normal saline 100 mL, continuous intravenous pumping for 3 h, twice daily. Patients in the treatment group were po administered with Angong Niuhuang Pills on the basis of the control group, 1 pill/time, once daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and Barthel index, NHISS scores, mean cerebral blood flow velocity, and serum indexes (serum levels of NSE, BDNF, hs-CRP, TNF-α, and IL-8) in two groups were compared. Results After treatment, the total effective rate of the treatment group (95.00%) was significantly higher than that of the control group (83.33%) (P<0.05). After treatment, Barthel index score was significantly increased in the two groups, but NHISS score was significantly decreased in the two groups (P<0.05). And the improvement of score scores in the treatment group was significant (P<0.05). After treatment, the mean blood flow velocity of middle cerebral artery, anterior cerebral artery and posterior cerebral artery in two groups were significantly increased (P<0.05). And the improvement of mean blood flow velocity in the treatment group was significant (P<0.05). After treatment, the serum levels of NSE in two groups were significantly decreased, but the serum levels of BDNF were significantly increased (P<0.05). And the improvement of serum levels in the treatment group was significant (P<0.05). After treatment, the serum levels of hs-CRP, TNF-α, and IL-8 in two groups were significantly decreased (P<0.05). And the serum inflammation indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Angong Niuhuang Pills combined with Argatroban Injection has clinical curative effect in treatment of acute cerebral infarction, can improve the neurological function and quality of life of patients, regulate the serum index, which has a certain clinical application value.
[中图分类号]
R971
[基金项目]
河南省中医药科学研究专项课题(2014ZY02096)